Effort‐reward imbalance at work and weight changes in a nationwide cohort of workers in Denmark

Abstract

Objective: To investigate the relation between effort-reward imbalance (ERI) at work and subsequent weight changes.Methods: We included participants from a population-based cohort of workers in Denmark (mean age = 47 years, 54% women) with two (n = 9005) or three repeated measurements (n = 5710). We investigated the association between (a) ERI (ie, the mismatch between high efforts spent and low rewards received at work) at baseline and weight changes after a 2-year follow-up (defined as ≥5% increase or decrease in body mass index (BMI) vs stable), and (b) onset and remission of ERI and subsequent changes in BMI. Using multinomial logistic regression we calculated risk ratios (RR) and 95% confidence intervals (CI), adjusted for sex, age, education, cohabitation, migration background, and follow-up time.Results: After 2 years, 15% had an increase and 13% a decrease in BMI. Exposure to ERI at baseline yielded RRs of 1.09 (95% CI: 0.95-1.25) and 1.04 (95% CI: 0.90-1.20)for the increase and decrease in BMI, respectively. There were no differences between sex and baseline BMI in stratified analyses. The onset of ERI yielded RRs of 1.04 (95% CI: 0.82-1.31) and 1.15 (95% CI: 0.84-1.57) for subsequent increase and decrease in BMI. The RRs for the remission of ERI and subsequent increase and decrease in BMI were 0.92 (95% CI: 0.71-1.20) and 0.78 (95% CI: 0.53-1.13), respectively. Of the ERI components, high rewards were associated with a lower risk of BMI increase. ---This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

The multiple roles of life stress in metabolic disorders

“…Figures have been adapted from references 39,47,51 . *Numbers are hazard ratios for being exposed (versus not being exposed) to various stressors, stress appraisal and proxy measures of the stress response from references 23,96,124,125,131,132,[135][136][137][138][139][140][141][142][143][144][145][146][147][148][149][150] . The strongest associations with obesity, diabetes and liver disease are observed for Cushing's syndrome (a disease with high cortisol secretion), adverse childhood experiences, and low occupational position.…”

“…and meta-analyses on various stressors in relation to obesity, type 2 diabetes and liver disease are summarised in table 3 23,96,124,125,131,132,[135][136][137][138][139][140][141][142][143][144][145][146][147][148][149][150] . The relative risk estimates have varied between 1.1 and 1.5 for markers of stress, such as PSTD, workplace bullying, psychological distress, job strain, long working hours, effort-reward imbalance and stressful life events.…”

Occupational psychosocial factors and cardiovascular disease.

“…Body mass index (BMI) and obesity have been associated with sedentary work (Choi et al, 2010b), long hours (Virtanen et al, 2020), shift work Myers et al, 2021), and job strain, in some cases (Choi et al, 2014), but not ERI (Nordentoft et al, 2020). Job stressors may influence weight gain directly through circadian rhythm disturbances (e.g., sleep disturbances due to shift work or long work hours; see Figure 16.1, arrows H and K) and activation of the hypothalamic-pituitary-adrenocortical (HPA) axis and metabolic changes (neuroendocrine pathway; arrows G, I-K; Choi et al, 2011;Solovieva et al, 2013).…”

Gratifikationskrisen, Arbeitsfähigkeit und Wunsch nach beruflichen Veränderungen – eine Querschnittsstudie bei Pflegepersonen

“…Im Zusammenhang mit der Arbeitssituation zeigen sich insbesondere die Faktoren Geld, Wertschätzung, Karrieremöglichkeiten und Arbeitsplatzsicherheit als relevante Komponenten für arbeitsbezogene Belohnungen [14]. Das Verhältnis von Aufwand und Belohnung, gemessen mit dem ERI, wird für Personen unterschiedlicher Berufsgruppen mit 0,8 [15] bis 0,92 als positiv angegeben [16]. Im Rahmen der Nurses Early Exit (NEXT) Studie lag der ERI für deutsche Pflegende bei 0,82 (0,35) [17].…”